CMS Formulary

Displaying 19401-19410 of 1611142 results.
ID: 19401
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19402
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1927682
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14
ID: 19403
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19404
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19405
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19406
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19407
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19408
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 19409
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661799
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 19410
Formulary ID: 00021005
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 30